MX2011004465A - Reduced-pressure, deep-tissue closure systems and methods. - Google Patents

Abstract

A reduced-pressure, deep-tissue closure device for applying a closing force on a deep tissue includes a contractible matrix that is formed with a first plurality of apertures and which has a first side and a second, inward-facing side. The contractible matrix is for disposing proximate to the deep tissue. A reduced-pressure source is fluidly coupled to the contractible matrix and operable to deliver reduced pressure to the contractible matrix. When under reduced pressure, the contractible matrix grips the deep tissue adjacent the contractible matrix and provides a closing force on the deep tissue. A system and method are also presented.

Description

METHODS AND SYSTEMS OF DEEP TISSUE CLOSURE WITH PRESSURE REDUCED RELATED REQUESTS The present invention claims the benefit, under 35 USC § 119 (e), of the filing of the Provisional Patent Application of E.U. serial number 61 / 109,448, entitled "Reduced-Pressure, Deep-Tissue Closure System and Method" ("System and Closing Method of Deep Tissue with Reduced Pressure"), filed on October 29, 2008; the Provisional Patent Application of E.U. Serial Number 61 / 109,486, entitled "Reduced-Pressure, Abdominal Treatment System and Method" ("System and Method of Abdominal Treatment with Reduced Pressure"), filed on October 29, 2008; the Provisional Patent Application of E.U. Serial Number 61 / 109,390, entitled "Open-Cavity, Reduced-Pressure Wound Dressing and System" ("Wound Dressing and System with Reduced Pressure for Open Cavity"), filed on October 29, 2008; and the Provisional Patent Application of E.U. Serial Number 61 / 109,410, entitled "Reduced-Pressure, Wound Closure System and Method", filed on October 29, 2008. All of these provisional applications are incorporated into the present by reference for all purposes.

BACKGROUND - - The present invention relates in general to medical treatment systems and, more particularly, to systems and methods for deep tissue closure with reduced pressure.

If the etiology of a wound, or damaged area of tissue, is trauma, surgery, or other cause, proper wound care, or injury, is important for the result. There are unique challenges when the wound includes locations that require re-entry, for example, the peritoneal cavity and more generally the abdominal cavity. Frequently when surgery or trauma includes the abdominal cavity, establishing a wound management system that facilitates re-entry allows easier and better care and helps treat such things as peritonitis, abdominal compartment syndrome, and infections that can inhibit final wound healing and internal organs. To provide such care, it may be desirable to remove unwanted fluids from the cavity, assist in proximity to the fascia and other tissues, and ultimately help to provide a closing force on the wound itself at the level of the epidermis.

It may be necessary to treat several deep tissues, for example, fat, muscle, or particularly fascia, when the abdomen is temporarily closed. Unless stated otherwise, as used herein, "or" does not require mutual exclusivity. If I dont know - - treated, the deep tissue may retract further into the abdominal cavity and subsequently cause difficulties. The surgeon can suture the deep tissue, for example, the fascia, while placing the fascia under tension. However, this can be problematic, if reduced pressure treatment is desired in the area or if dressing replacement is needed. In addition, suture of deep tissue can sometimes cause necrosis. If a complex wound, for example a wound that is infected is involved, the fascia may be very fragile and may not be able to support the suture. If a mesh is used to assist in the latter situation, removal of the mesh can be difficult and may require surgery. At the same time, if the deep tissue, especially the fascia, does not close, the situation can lead to hernias and other complications.

In addition to accessing the re-entry cavity, it may be desirable to remove fluids from the cavity. It may also be desirable to provide therapy with reduced pressure to the tissue or wound, including wounds that may be within the abdominal cavity. This treatment (often referred to in the medical community as "negative pressure wound therapy," "reduced pressure therapy," or "vacuum therapy") can provide several benefits, including faster healing and increased formulation of granulation tissue.

- - It would be desirable to provide a system and method that can facilitate treatment with reduced pressure and help close deep tissue in a manner that avoids or minimizes complications, such as deep tissue retraction or necrosis.

SUMMARY The problems with deep tissue closure systems, devices, and methods are addressed by the systems, devices, and methods of the illustrative embodiments described herein. According to an illustrative embodiment, a deep tissue closure system with reduced pressure for applying a closing force close to a deep tissue includes a contractile matrix which is formed with a first plurality of openings, and which has a first side and a second side facing inwards. A source of reduced pressure is fluidly coupled to the contractile matrix and operable to provide reduced pressure to the contractile matrix.

According to another illustrative embodiment, a deep tissue closure system with reduced pressure for applying a closing force close to a deep tissue includes a contractile matrix that is formed with a first plurality of openings and has a first side and a second side facing inwards. The second side it is formed with a first plurality of cells, each cell having cell walls open. A second plurality of openings is formed in the cell walls. A source of reduced pressure is fluidly coupled to the contractile matrix and operable to provide reduced pressure to the contractile matrix.

According to another illustrative embodiment, a system of treatment with reduced pressure for applying a closing force to a deep tissue wound in a body cavity of a patient includes a contractile matrix that is formed with a first plurality of openings and that has a first side and a second side facing inwards. The second side is formed with a plurality of cells and with a second plurality of openings. The illustrative reduced pressure treatment system also includes a dispensing member operable to distribute a reduced pressure and a reduced pressure source fluidly coupled to the distributor member and the contractile matrix. The source of reduced pressure supplies reduced pressure to the distributor member and to the contractile matrix. The illustrative reduced pressure treatment system also includes a sealant member operable to provide a pneumatic seal on the body cavity.

According to another illustrative embodiment, a method for manufacturing a pressure treatment system Reduced for applying a closing force to a deep tissue in a body cavity of a patient includes the steps of: forming a contractile matrix having a first plurality of openings, and having a first side and a second side facing inward. The second side is formed with a plurality of cells and is further formed with a second plurality of openings. The method further includes providing a dispensing member operable to distribute a reduced pressure and providing an operable sealing member to provide a pneumatic seal on the body cavity.

According to another illustrative embodiment, a method for providing a closing force to a deep tissue in a body cavity of a patient includes the step of placing a contractile matrix in the body cavity adjacent to the deep tissue. The contractile matrix is formed with a plurality of openings and has a first side and a second side facing inward. The second side is formed with a first plurality of cells and with a second plurality of openings. The method may further include fluidly coupling a source of reduced pressure to the contractile matrix and sealing the body cavity with a sealing member.

Other objectives, characteristics, and advantages of the illustrative modalities will be apparent with reference to the drawings and to the following detailed description.

BRIEF DESCRIPTION OF THE DRAWINGS Figure 1 is a schematic diagram, with a cross-sectional portion, of an illustrative embodiment of a deep tissue closure system with reduced pressure; Figure 2 is a cross-sectional, schematic view of a detail of the deep tissue closure system with reduced pressure illustrative of Figure 1 showing a portion of a contractile matrix; Figure 3 is a perspective, schematic view of a first side of an illustrative contractile matrix; Figure 4 is a perspective, schematic view of a second side of the illustrative contractile matrix of Figure 3; Figure 5 is a schematic plan view of another illustrative embodiment of a contractile matrix; Figure 6 is a detail of a portion of the contractile matrix of Figure 5; Y Figure 7 is a perspective, schematic view of another illustrative embodiment of a contractile matrix.

DETAILED DESCRIPTION OF THE ILLUSTRATIVE MODALITIES In the following detailed description of the - - illustrative modalities, reference is made to the accompanying drawings that form a part thereof. These modalities are described in sufficient detail to enable the person skilled in the art to practice the invention, and it is understood that other modalities may be used and that logical, structural, mechanical, electrical and chemical changes may be made without departing from the spirit or scope of the invention. invention. In order to avoid unnecessary detail in order to allow the persons skilled in the art to practice the modalities described herein, the description may omit certain information known by the persons skilled in the art. Therefore, the following detailed description should not be taken in a limiting sense, and the scope of the illustrative embodiments is defined only by the appended claims.

Referring to Figures 1-2, a deep tissue closure system with reduced pressure 100 is presented, which includes a deep tissue closure device with reduced pressure 102. The deep tissue closure system with reduced pressure 100 and the device deep tissue closure with reduced pressure 102 are for use close to a tissue site 104 within a body cavity 106 that includes a deep tissue, such as a deep tissue wound 108 in the patient's fascia 110. In some cases, the closure system 100 and - - Closing device 102 can be used in other tissues. As used herein, "wound" refers to a damaged area of tissue or tissue regardless of the cause of the damage.

In this illustrative embodiment, a wound extends through the epidermis 112 of a patient, fat layer 114, muscle 116, and fascia 110. Of these layers, particular attention is often given to closing fascia 110. Although this mode Illustrative is focused on fascia 110, it should be understood that the deep tissue closure system with reduced pressure 100 and the deep tissue closure device with reduced pressure 102 can be used in other deep tissues or deep tissue wounds.

The deep tissue wound 108 in fascia 110, in this illustration, includes a laceration or incision that creates fascia edges 118. It is desired to close or push the fascia edges 118 together with a closing force. As used herein, unless otherwise indicated, "or" does not require mutual exclusivity. When re-entry may be necessary, a temporary closure of the fascia 110 is preferred. In this way, it is desirable to close or apply a closing force on the fascia 110 when approaching the fascia edges 118. As will be described below, the device of deep tissue closure with reduced pressure 102 of this illustrative modality helps to close or apply - - a closing force on fascia 110.

In this illustrative embodiment, the body cavity 106 is an abdominal cavity and the tissue site 104 is a portion of an abdominal contents 122 or tissue close to the abdominal contents 122. To provide open wound management using the tissue closure system deep with reduced pressure 100, it may be desirable to first place a body cavity dressing 120 on abdominal contents 122. Abdominal content 122 provides support for body cavity dressing 120.

The body cavity dressing 120 may include an encapsulated, non-sticky distributor member 124. The encapsulating layers of the body cavity dressing 120 may be formed with fenestrations or openings, such as openings 126, which allow fluids to enter the body cavity pocket. 120. The body cavity dressing 120 can be formed with a non-adherent surgical drape having a discrete plurality of lower limbs. The body cavity dressing 120 is placed on the abdominal contents 122 and is preferably placed, at least in part, on one or more of the paracolic channels 128. The deep tissue closure device with reduced pressure 102 can then be placed at the dressing of adjacent body cavity 120 just below fascia 110 (for the orientation shown in FIGURE 1).

- - The deep tissue closure device with reduced pressure 102 includes a contractile matrix 130, having a first side 132 and a second side facing inward 134 (given to the patient). The first side 132 is to be placed adjacent to the fabric layer, for example, the fascia 110, which the closing device 102 intends to close or push. The contractile matrix 130 can be formed with a first plurality of openings 136 through a structure or contractile material. The first plurality of openings 136 can take any shape, for example, slits (linear openings), rectangular openings, irregularly shaped openings, etc. The contractile matrix 130 can be formed with a plurality of cells, or compartments or partial compartments, for example, open cells 138, on the second side facing inwardly 134 or on any portion of the contractile matrix 130. The first plurality of openings 136 it may be in fluid communication with the first plurality of cells 138. As shown in Figure 2, the first plurality of cells 138 may be formed with cell walls 140 and may include a second plurality of openings 142.

When reduced pressure is supplied to the contractile matrix 130, a clamping force and an inward force develops. The reduced pressure acts through the first plurality of openings 136 to provide the - - fastening force on the fascia 110. The holding force holds, or holds, the fascia 110. The reduced pressure can be supplied to the contractile matrix 130 from below (for the orientation shown) through the body cavity dressing 120 and in particular through the openings 126 or through a distributor 144. The holding force on the fascia 110 is represented by arrows 146.

In addition to providing a clamping force through the openings 136, the reduced pressure also pushes the contractile matrix 130 inward, i.e., at the discretion shown by the arrows 148. "Inward" in this context means toward a central portion of the deep tissue closure device with reduced pressure 102. Alternatively, "inward" can be defined as in a direction that would push the tissue, eg, the fascia 110, toward the edges 118 of the tissue wound 108 for a surgical device. deep tissue closure with reduced pressure 102 deployed. Since the reduced pressure acts on the contractile matrix 130, the contractile matrix 130 holds the fascia 110 and changes from an uncontracted position to a contracted position. In one embodiment, the contractile matrix 130 includes cells that collapse laterally and thus contract. The side walls, which are flexible, of the cells approach each other under the influence of reduced pressure. Because the pressure reduced in the first - - plurality of openings 136 holds the fascia 110, and the reduced pressure also causes the contractile matrix 130 to contract, a closing force develops and is applied to the fascia 110 which pushes the fascia edges 118 towards closer approach. In this way, the fascia 110 undergoes a closing force and that causes the fascia 110 to close or push towards a closed position.

In one embodiment, the contractile matrix 130 includes a plurality of cells, for example, cells 138, which collectively define a first volume (Vi) when reduced pressure is not applied. When reduced pressure is applied to the cells, the cells collapse or otherwise move so that a second volume (V2) is defined. The second volume is smaller than the first volume (Vi), that is, Vi > V2, and this change in volume is associated with contraction.

As used herein, "reduced pressure" generally refers to a pressure less than ambient pressure at the site of tissue 104 that is subjected to treatment. In most cases, this reduced pressure will be lower than the atmospheric pressure at which the patient is located. Alternatively, the reduced pressure may be less than a hydrostatic pressure at the tissue site 104. Unless stated otherwise, the pressure values set forth herein are barometric pressures.

- - The distributor 144 is positioned within the body cavity 106 next to the deep tissue closure device with reduced pressure 102, which is close to the body cavity dressing 120. The distributor 144 can be supported by or placed adjacent the first side 132 of the matrix contractile 130. The term "distributor" as used herein generally refers to a substance or structure that is provided to assist in applying reduced pressure to, supplying fluids to, or removing fluids from, the tissue site 104 or other location. The manifold 144 typically includes a plurality of flow paths or channels that distribute fluids provided to and removed from the area around the manifold 144. The manifold 144 may include a plurality of flow paths or channels that interconnect to improve fluid distribution. The distributor 144 may be a biocompatible material that is capable of being placed in contact with tissue. Examples of dispenser 144 may include, without limitation, devices having structural elements installed to form flow channels, cellular foam, such as open cell foam, collections of porous tissue, and liquids, gels, and foams that include or cure to include flow channels. The dispenser 144 can be porous and can be made of foam, gauze, mat covered with felt, or any other material suitable for a particular biological application. In one embodiment, the dispenser 144 is a porous foam and includes a plurality of pores or interconnected cells that act as flow channels. The porous foam may be a cross-linked, open cell, polyurethane foam, such as a GranuFoam® material manufactured by Kinetic Concepts, Incorporated of San Antonio, Texas. Other modalities may include "closed cells." These closed cell portions of the distributor 144 contain a plurality of cells, most of which do not connect fluidly to adjacent cells. Closed cells can be selectively placed in distributor 144 to prevent fluid transmission through the perimeter surfaces of distributor 144. In some situations, distributor 144 can also be used to distribute fluids, such as medications, antibacterials, factors of growth, and other solutions to the wound 108 or the body cavity 106. Other layers or material may be included as part of the distributor 144, such as absorbent material, wicking material, hydrophobic material, hydrophilic material, etc.

A sealing member 154 is placed over a body cavity opening 156 of the body cavity 106 and provides a pneumatic seal suitable for the deep tissue closure system with reduced pressure 100 for - - retaining the reduced pressure within the body cavity 106. The sealing member 154 may be a cover that is also used to secure the dispenser 144 in a central portion of the body cavity dressing 120. Although the sealing member 154 may be waterproof or semi-permeable, the sealing member 154 is capable of maintaining a reduced pressure at the tissue site 104 after installation of the sealing member 154 over the body cavity opening 156. The sealing member 154 may be a flexible film or dust jacket formed from a base compound. silicone, acrylic, hydrogel or hydrogel-forming material, or any other biocompatible material that includes the desired impermeability or permeability characteristics for use with a tissue site or the deep tissue closure device with reduced pressure 102.

The sealing member 154 may further include a joining means 158 for securing the sealing member 154 to the epidermis of the patient 112. The attachment means 158 may take many forms. For example, the attachment means 158 may include an adhesive 160 placed in the sealing member 154 or in any portion of the sealing member 154 to provide the pneumatic seal. The adhesive 160 can be pre-applied and covered with a releasable reinforcement, or member, which is removed at the time of its application to the patient - - A reduced pressure interface 162, such as an elbow port 164, may be applied to the sealing member 154 to provide reduced pressure through the sealing member 154 and the distributor 144 and thus to the contractile matrix 130. The reduced pressure interface 162 may be used. for this purpose, but other approaches can also be used. For example, in one embodiment (not shown), a reduced pressure supply conduit 166 is placed directly towards the manifold 144. In the illustrative embodiment shown, the reduced pressure supply conduit 166 is fluidly coupled to a source of reduced pressure 168.

The reduced pressure source 168 can accommodate a wide range of reduced pressures. The range can include -50 to -400 mm Hg. In an illustrative embodiment, the reduced pressure source 168 may include preset selectors for -100 mm Hg, -125 mm Hg, and -150 mm Hg. The reduced pressure source 168 may also include a number of alarms, such as a blogging alarm, a leak alarm, or a low battery alarm. The reduced pressure source 168 may be a portable source, wall source, or other unit for abdominal cavities. The reduced pressure source 168 can selectively supply a constant pressure, intermittent pressure, dynamic pressure, or pressure with a fixed pattern.

- - An average portion 170 of the reduced pressure supply conduit 166 may include a number of devices, such as a representative device 172. The device 172 may be a fluid collecting member, or a reservoir for the container, to preserve sweat, ascites, and other fluids removed; a pressure feedback device; a volume detection system; a blood detection system; an infection detection system; a flow monitoring system; a filter; a temperature monitoring system; etc. Some representative devices 172, for example, the fluid collecting member, may be formed integral to the reduced pressure source 168. For example, a reduced pressure port 174 in the reduced pressure source 168 may include a filter member that includes one or more filters, such as a hydrophobic filter that prevents the liquid from entering the interior space. Multiple devices can be included.

The deep tissue closure system with reduced pressure 100 is operable to provide a closing force on fascia 110. In addition, the deep tissue closure system with reduced pressure can provide reduced pressure treatment within body cavity 106 and in or close to the tissue site 104. The reduced pressure treatment can be applied within the body cavity 106 and at the tissue site 104 to help - - promote the removal of ascites, sweat, and other fluids. The reduced pressure can also stimulate the growth of additional tissue. In the case of a wound at the tissue site 104, granulation tissue growth and removal of sweat and bacteria can help promote healing. In the situation of a nonwoven or non-defective tissue at the tissue site 104, the reduced pressure can be used to promote tissue growth that can be harvested and transplanted to another tissue site.

In operation, after the body cavity dressing 120 has been placed within the body cavity 106 and adjacent the abdominal contents 122, the deep tissue closure device with reduced pressure 102 can be placed adjacent to the deep tissue closure device with reduced pressure 102 and below fascia 110 (for the orientation shown in FIGURE 1). The dispenser 144 can then be inserted into the body cavity 106 and placed close to the deep tissue closure device with reduced pressure 102. The sealing member 154 can then be placed in the epidermis of the patient 112 over the body cavity opening 156 to form a seal pneumatic over the body cavity 106. The reduced pressure interface 162, e.g., elbow port 164, can be attached to the sealing member 154. The reduced pressure supply conduit 166 can - - coupling fluidly between the reduced pressure interface 162 and the reduced pressure source 168.

When the reduced pressure source 168 is activated, the reduced pressure is supplied through the reduced pressure supply line 166 to the reduced pressure interface 162 and thus to the distributor 144 and to the deep tissue closure device with reduced pressure 102. The reduced pressure experienced by the deep tissue closure device with reduced pressure 102 causes the deep tissue closure device with reduced pressure 102 to clamp the fascia 110 through the first plurality of openings 136 and contract. As the deep tissue closure device with reduced pressure 102 contracts, a closing force is experienced by the fascia 110 which is directed towards the fascia edges 118. The fascia edges 118 thus approach. The closing force experienced by the fascia 110 develops without the need to pierce or injure the fascia 110 or other tissue. In addition to approaching the fascia edges 118, the reduced pressure delivered to the reduced pressure interface 162, and thus to the distributor 144, provides reduced pressure treatment in the body cavity 106 and can provide reduced pressure treatment to the tissue near the site of 104 tissue Referring now to Figures 3 and 4, - - it presents another illustrative contractile matrix 200. The contractile matrix 200 has a first side 202 and a second side facing inwardly 204. Figure 3 presents the first side 202, and Figure 4 presents the second side facing inwardly 204. The contractile matrix 200 can be used in the deep tissue closure system with reduced pressure 100 of Figure 1. In this particular illustrative embodiment, the contractile matrix 200 is formed with a solid circular shape, but numerous other forms, such as elliptical shape shown in Figure 5, an arched shape, rectangular shape, etc. The first side 202 of the contractile matrix 200 has a first plurality of openings 206 formed there through and extending to the second side facing inwardly 204. As shown in Figure 4, a plurality of cells 208 is formed on the second inward facing side 204. Each cell of the plurality of cells 208 has cell walls 210. The cells 208 each have an opening 206 and an open cell portion. Each cell wall 210 may have one or more openings through the cell wall 210 to form a second plurality of openings analogous to the second plurality of openings 142 in Figure 2. In this particular illustrative embodiment, the plurality of cells 208 it can be formed as alveolar cells centered around each of the first plurality of openings - - 206.

Referring now to Figures 5 and 6, another illustrative embodiment of a contractile matrix 300 is presented. The contractile matrix 300 can be used in the deep tissue closure system with reduced pressure 100 of Figure 1. The contractile matrix 300 has a first side (not shown) and a second side facing inwardly 304. The contractile matrix 300 in this particular illustrative embodiment is formed with an oval shape having a central opening 306, but the contractile matrix 300 can be formed without the central opening 306. The second inward facing side 304 of the contractile matrix 300 may be formed with a plurality of cells 308. A first plurality of openings 310 may be formed through the contractile matrix 300 and may be in fluid communication with the plurality of cells 308. The plurality of cells 308 can be formed by a plurality of interconnected cell walls 312. As with the embodiment shown in Figure 2, a plurality of interconnected cell walls 312 can be formed with intercellular openings (not shown) to form a second plurality of openings.

Referring now to Figure 7 another illustrative embodiment of a contractile matrix 400 is presented. The contractile matrix 400 can be used in the deep tissue closure system with reduced pressure, 100 of the - - Figure 1. The contractile matrix 400 in this illustrative embodiment is rectangular in shape and has a first plurality of openings 410 running from a first side 402 to a second side facing the interior 404 of the contractile matrix 400. A second plurality of openings 411 may connect the first plurality of openings 410 or some portion thereof.

In an alternative embodiment, the contractile matrix 400 may have openings 410 in the first side 402 but not corresponding opening in the second inwardly facing side 404. In this manner, the contractile matrix 400 has cells that open only to the first side 402 and may have openings 411, which provide reduced pressure to the cells. When the reduced pressure is supplied through the openings 411, the deep tissue is held by the openings 410 and the sidewalls of the cells are pushed closer to each other causing the contractile matrix 400 to contract.

A number of different substances can be used to form the contractile matrix 130 (Figure 1), contractile matrix 200 (Figures 3 and 4), contractile matrix 300 (Figures 5 and 6), and contractile matrix 400 (Figure 7). Typically, a flexible, contractile material is used. For example, these shrinkable matrices 130, 200, 300, 400 can be formed of thermal plastic elastomers (TPE), - - flexible; thermoplastic urethane (TPU); silicone rubber; etc. In addition, a number of different cell geometries can be used in the contractile matrices. For example, possible cell geometries include alveolar, round-shaped, diamond-shaped, mesh-shaped cells, etc. The foam is not used for the contractile matrices. The material from which the contractile matrices are formed preferably prevents the inward growth of any tissue. In an illustrative embodiment, the contractile matrix can be formed with an alveolar TPU material including honeycomb cells that are formed by fusion bonding. Although the foam is not typically used, in one embodiment, the contractile matrix may be formed of a foam, encapsulated or sealed member having openings for holding the tissue and a reduced pressure supply interface.

In another illustrative embodiment, the contractile matrix can be formed of a thermal plastic elastomer (TPE) that allows expansion and contraction in the xy plane (the plane within the page for Figure 5) while retaining a fairly constant dimension in the z direction (leaving the page in Figure 5). In this mode, the contractile matrix may have a stronger (or more material) material concentrated in the z direction than in the xy directions. Alternatively or in addition, they can be added - - empty to recommend the collapse pattern. Alternatively or in addition, resistance members, for example, filaments, may be added in the z-direction to avoid collapse in that direction. In another illustrative embodiment, the contractile matrix can be formed using a thermoplastic urethane material (TPU) that can have an additional film in the contractile matrix on the first side, for example, on the side 302 of the contractile matrix 300 of Figure 5 These are only some illustrative examples.

In an alternative embodiment, a shrinkage matrix can be formed to contract under reduced pressure by using a pneumatic element, or device, that contracts under reduced pressure. In this way, for example, with reference to Figure 7, the openings 410 can be sealed at the top and bottom to form a plurality of pneumatic chambers. The second openings 411 may remain open to receive reduced pressure. As reduced pressure is supplied to the chambers formed of the first openings 410, the chambers collapse and provide an inwardly contracting force. Other pneumatic devices may be used, but in each case, the pneumatic device preferably holds the fascia without causing a wound and contracts under reduced pressure.

- - Although the present invention and its advantages have been described in the context of certain illustrative, non-limiting embodiments, it is to be understood that various changes, substitutions, and alterations may be made without departing from the scope of the invention as defined by the appended claims.

Claims (37)

1. A deep tissue closure system with reduced pressure to apply a closing force close to a deep tissue, the system comprising: a contractile matrix to be placed close to the deep tissue, forming with a first plurality of openings in a first side of the contractile matrix, further comprising a plurality of cells, wherein the contractile matrix has a first side and a second side facing inward, wherein the plurality of cells has a first volume (Vi) when it is not under reduced pressure and a second volume (V2) when it is under reduced pressure, where Vi > V2; Y a source of reduced pressure fluidly coupled to the contractile matrix and operable to supply reduced pressure to the contractile matrix.

2. The reduced pressure deep tissue closure system of claim 1, wherein the cells are in fluid communication with the first plurality of openings.

3. The deep tissue closure system with reduced pressure of claim 1, wherein the cells have side walls that are flexible.

4. The reduced pressure deep tissue closure system of claim 1, wherein the plurality of cells further comprises a second plurality of openings that fluidly couple the plurality of cells.

5. The system of claim 1, wherein the contractile matrix is operable, when a reduced pressure is supplied by the source of reduced pressure, to develop a clamping force in the deep tissue adjacent to the first side of the contractile matrix and to move from a position not contracted to a contracted position.

6. The system of claim 1, wherein the contractile matrix is operable, when a reduced pressure is supplied by the source of reduced pressure, to develop a clamping force in the deep tissue adjacent to the first side of the contractile matrix and generate the force of closure in the deep tissue.

7. The system of claim 2, wherein the contractile matrix comprises an alveolar matrix.

8. The system of claim 2, wherein the contractile matrix comprises an alveolar matrix of thermoplastic elastomers.

9. The system of claim 2, wherein the plurality of cells comprises a plurality of cells in gear shape.

10. A reduced pressure closure system for applying a closure force close to a tissue, the deep tissue closure system comprising reduced pressure: a contractile matrix that is formed with a first plurality of openings and having a first side and a second side facing inwardly, the second side facing inwardly being formed with a plurality of cells, each cell having cell walls and at least one intercellular opening that is formed in each open cell of the plurality of cells, the matrix being contractible to be positioned next to the tissue; Y a source of reduced pressure fluidly coupled to the contractile matrix and operable to supply reduced pressure to the contractile matrix.

11. The reduced pressure tissue closure system of claim 10, wherein the contractile matrix is operable when reduced pressure is supplied by the source of reduced pressure to develop a clamping force in the tissue adjacent to the first side of the contractile matrix and to move from a non-contracted position to a contracted position.

12. The reduced pressure tissue closure system of claim 10, wherein the matrix The contractile is operable when a reduced pressure is supplied by the source of reduced pressure to develop a clamping force in the tissue adjacent to the first side of the contractile matrix and generate the closing force in the tissue.

13. The reduced pressure tissue closure system of claim 10, wherein the contractile matrix comprises an alveolar matrix.

14. The reduced pressure tissue closure system of claim 10, wherein the contractile matrix comprises an alveolar matrix of thermoplastic elastomers.

15. The reduced pressure fabric closure system of claim 10, wherein the plurality of cells comprises a plurality of cells in the form of a mesh.

16. A treatment system with reduced pressure for applying a closing force to a deep tissue wound in a body cavity of a patient and for providing reduced pressure treatment in the body cavity, the system comprising: a contractile matrix that is formed with a first plurality of openings and having a first side and a second side facing inwardly, the second side facing inwardly with a second side being formed plurality of openings, the contractile matrix being positioned close to the deep tissue wound; an operable distributor member for distributing a reduced pressure; a source of reduced pressure fluidly coupled to the distributor member and to the contractile matrix, the source of pressure being reduced to supply reduced pressure to the distributor member and to the contractile matrix; Y an operable sealing member for providing a pneumatic seal on the body cavity.

17. The reduced pressure treatment system of claim 16, wherein the contractile matrix is operable when reduced pressure is supplied by the pressure source. reduced to develop a clamping force in a deep tissue adjacent to the first side of the contractile matrix and to move from a non-contracted position to a contracted position.

18. The reduced pressure treatment system of claim 16, wherein the contractile matrix is operable when reduced pressure is supplied by the source of reduced pressure to develop a clamping force in a deep tissue adjacent to the first side of the contractile matrix and for generate the closing force in the deep tissue wound.

19. The reduced pressure treatment system of claim 16, wherein the contractile matrix comprises an alveolar matrix.

20. The reduced pressure treatment system of claim 16, wherein the contractile matrix comprises an alveolar matrix of thermoplastic elastomers.

21. The reduced pressure treatment system of claim 16, wherein the contractile matrix comprises a material having a plurality of cells and wherein the material comprises a plurality of cells in the form of a mesh.

22. A method for manufacturing a treatment system with reduced pressure to apply a closing force to a deep tissue in a body cavity of a patient, the method comprising the steps of: forming a contractile matrix having a first plurality of openings, and having a first side and a second side facing inwardly, the contractile matrix being disposed proximate the deep tissue; providing an operable distributor member to distribute a reduced pressure; Y providing an operable sealing member to provide a pneumatic seal on the body cavity.

23. The method for manufacturing a reduced pressure treatment system of claim 22, in where the second side facing inward of the contractile matrix is formed with a plurality of cells, and is further formed with a second plurality of openings.

24. The method for manufacturing a pressure reduced treatment system of claim 22, wherein the second side facing inwardly of the contractile matrix is formed with a plurality of cells, and is further formed with a second plurality of openings; and wherein the step of forming a contractile matrix comprises forming the contractile matrix of an alveolar matrix.

25. The method for manufacturing a pressure reduced treatment system of claim 22, wherein the second side facing inwardly of the contractile matrix is formed with a plurality of cells, and is further formed with a second plurality of openings; and wherein the step of forming a contractile matrix comprises forming the contractile matrix from an alveolar matrix of thermoplastic elastomers.

26. The method for manufacturing a pressure reduced treatment system of claim 22, wherein the second side facing inwardly of the contractile matrix is formed with a plurality of cells, and is further formed with a second plurality of openings; and wherein the step of forming a contractile matrix comprises forming the plurality of cells as a plurality of cells in the form of gear.

27. A method for providing a closing force to a tissue in a body cavity of a patient, the method comprising the steps of: placing a contractile matrix in the body cavity adjacent to the tissue, wherein the contractile matrix is formed with a first plurality of openings, and has a first side and a second side facing inward, and has a plurality of cells, and being formed also with a second plurality of openings for fluidly coupling the plurality of cells; Y provide reduced pressure to the contractile matrix.

28. The method of claim 27 wherein the step of providing reduced pressure comprises the steps of: seal pneumatically the body cavity; and fluidly coupling a source of reduced pressure to the contractile matrix.

29. The method of claim 27, wherein the plurality of cells has a first volume (Vi) when it is not under reduced pressure and a second volume (V2) when it is under reduced pressure, and wherein Vi > V2

30. The method of claim 27 further comprising the step of placing a distributor member ? within the body cavity and fluidly coupling the distributor member to the source of reduced pressure.

31. The method of claim 27, wherein the plurality of cells is in fluid communication with the first plurality of openings.

32. The method of claim 27, wherein the cells have side walls that are flexible.

33. The method of claim 27, wherein the contractile matrix is operable when reduced pressure is supplied by the source of reduced pressure to develop a clamping force in the deep tissue adjacent to the first side of the contractile matrix and to move from a non-contracting position. contracted to a contracted position.

34. The method of claim 27, wherein the contractile matrix is operable when reduced pressure is supplied by the source of reduced pressure to develop a clamping force in the deep tissue adjacent to the first side of the contractile matrix and generate the closing force in the deep tissue.

35. The method of claim 27, wherein the contractile matrix comprises an alveolar matrix.

36. The method of claim 27, wherein the contractile matrix comprises an alveolar matrix of thermoplastic elastomers.

37. The method of claim 27, wherein the plurality of cells comprises a plurality of cells in the form of a mesh.